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Mr. Thomas Russell Prieskorn, PA-C
Medical Physician Assistant in Shelton, Washington
NPI 1366421174

Thomas Russell Prieskorn is a Medical Physician Assistant based in Shelton, WA and is specialized in Medical. Thomas Russell Prieskorn practices in Shelton, WA and has the professional credentials of PA-C. The NPI Number for Thomas Russell Prieskorn is 1366421174 and holds a License No. PA10004942 (Washington).

The current practice location address for Thomas Russell Prieskorn is 901 Mountain View Dr, Shelton, WA and can be reached out via phone at 360-426-1611.

Location: 901 Mountain View Dr, Shelton, WA, 98584-5001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366421174
Provider Name
Thomas Russell Prieskorn
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
901 Mountain View Dr, Shelton, WA, 98584-5001
Phone Number
360-426-1611
Fax Number
Provider Enumeration Date
01/10/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8466955 05 WA
institution
Provider Business Practice Location Address Details
Address
901 Mountain View Dr
City
Shelton
State
Washington
Zip
98584-4401
Phone Number
360-426-1611
Fax Number
person
Provider Business Mailing Address Details
Address
901 Mountain View Dr
City
Shelton
State
Washington
Zip
98584-4401
Phone Number
360-426-1611
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
PA10004942 (Washington)
Definition
Definition to come...
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